Articles: postoperative-pain.
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Systemic application of analgesics is still the most frequently used method of postoperative relief of pain. However, neither intermittent intramuscular nor intermittent intravenous application can provide the patient with a continuous level of analgesia. Lipid-soluble analgesics or those with polar binding that are rapidly metabolized demonstrate an rapid effectiveness. ⋯ After an initial bolus injection, the continuous infusion of an analgesic is guaranteed and may be completed by the patient with several bolus injections. PCA requires careful monitoring. We suggest that a special analgesia team to take care of the patient in special analgesia units might be appropriate in the future.
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Anesthesia and analgesia · Mar 1988
Randomized Controlled Trial Clinical TrialPostoperative effects of intrathecal morphine in coronary artery bypass surgery.
To determine whether intrathecal morphine is effective in decreasing analgesic and antihypertensive drug requirements after coronary artery bypass (CAB) surgery, a prospective, randomized, double-blind study was designed. Approximately 30 minutes before induction of anesthesia with IV sufentanil and diazepam, and 2 hours before heparinization, one group of patients (n = 16) were given morphine 0.5 mg, while the control group (n = 14) were given placebo intrathecal injections through 22- or 25-gauge lumbar puncture needles. Intraoperatively, there were no differences in the numbers of patients requiring vasodilator drugs or volatile agent titration. ⋯ There were no differences in pain scores, and the only complications (itching, nausea and vomiting) were infrequent. It is concluded that an intrathecal dose of 0.5 mg of morphine is efficacious in reducing analgesic and antihypertensive drug requirements after CAB surgery. Whether these results are clinically important enough to warrant the theoretical risks of postheparinization lumbar hematoma is a topic for further investigation.
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Patient-controlled analgesia (PCA) with a microprocessor-operated infusion syringe was first suggested for human use in 1965. Clinical studies from the United States and Europe have shown this form of analgesia to be well accepted by adults, but the use of this technology for children has not been studied. We evaluated PCA in 15 consecutive pediatric surgical patients between the ages of 11 and 18 years undergoing major thoracic or abdominal surgery. ⋯ PCA is found to be a safe and effective means of analgesia in pediatric patients. Adequate pain relief was achieved with less analgesia and with less nursing attention. This technology is recommended for postoperative pediatric patients.
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Comparative Study Clinical Trial
Epidural narcotic and patient-controlled analgesia for post-cesarean section pain relief.